US11026698B2 - Osteotomy system and method of use - Google Patents

Osteotomy system and method of use Download PDF

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Publication number
US11026698B2
US11026698B2 US17/082,862 US202017082862A US11026698B2 US 11026698 B2 US11026698 B2 US 11026698B2 US 202017082862 A US202017082862 A US 202017082862A US 11026698 B2 US11026698 B2 US 11026698B2
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United States
Prior art keywords
bone
bone plate
track
plate
distal
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Active
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US17/082,862
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English (en)
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US20210137534A1 (en
Inventor
Jorge L. Orbay
Brian A. Cooke
Edward J. Tremols
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Skeletal Dynamics LLC
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Skeletal Dynamics LLC
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Priority to US17/082,862 priority Critical patent/US11026698B2/en
Assigned to SKELETAL DYNAMICS, INC. reassignment SKELETAL DYNAMICS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: COOKE, BRIAN A., ORBAY, JORGE L., TREMOLS, EDWARD J.
Publication of US20210137534A1 publication Critical patent/US20210137534A1/en
Priority to US17/324,815 priority patent/US11701129B2/en
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Publication of US11026698B2 publication Critical patent/US11026698B2/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A61B17/151—Guides therefor for corrective osteotomy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1796—Guides or aligning means for drills, mills, pins or wires for holes for sutures or flexible wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A61B17/8014—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the extension or compression force being caused by interaction of the plate hole and the screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length

Definitions

  • the invention relates generally to orthopedic implants and surgical devices and systems, and, in particular, to a plate and cutting guide system for use in bone osteotomy surgery and to stabilize a shortened bone, including but not limited to, the ulnar bone.
  • a bone plate comprising a cutting guide which facilitate performance of an osteotomy and stabilization of the shortened bone.
  • It is an object of the instant invention to provide a bone cutting system comprising a bone plate and a cutting guide adapted to slidingly engage by inserting the cutting guide into the bone plate from the overhead direction, the cutting guide adapted to facilitate parallel cutting planes on a bone at readily ascertainable offset distances.
  • the bone plate comprises a substantially rigid plate including an elongated body having a proximal end and a distal end and defining a longitudinal body axis; the plate comprising a bone contacting side, and opposing side, a left sidewall and a right sidewall, all of which extend between the proximal end of the plate and the distal end of the plate and all of which are substantially aligned with the longitudinal body axis; a proximal elongated slot extending through the plate between the opposing side and the bone contacting side located adjacent to the proximal end of the plate, the proximal elongated slot adapted to receive a bone screw; a distal elongated slot extending through the plate between the opposing side and the bone contacting side and adjacent to the proximal elongated slot but located distally on the plate relative to the proximal elongated slot, the distal elongated slot adapted to receive a bone screw; one or more bone screw holes extending through the plate
  • the cutting guide comprises a handling feature; left and right guide walls extending downwardly from the handling feature and terminating respectively in left and right horizontal guide blades, the left and right horizontal blades adapted to mate with the left and right tracks of the bone plate respectively; an arm extending downward from one of the handling feature, the right guide wall and the left guide wall, and comprising a flange; a cutting slot disposed on the flange; wherein when the left and right horizontal blades are engaged with the left and right tracks of the bone plate respectively; the cutting guide slides in a proximal-distal direction relative to the bone plate.
  • FIG. 1A illustrates a top isometric view of a bone plate according to one embodiment of the present invention adapted for use in an ulnar shortening osteotomy.
  • FIG. 1B illustrates a bottom isometric view of a bone plate according to the embodiment shown in FIG. 1A .
  • FIG. 1C illustrates a detailed view of the guiding track of the bone plate shown in FIGS. 1A and 1B .
  • FIG. 1D illustrates a cross-sectional view of the bone plate shown in FIGS. 1A and 1B taken from a location having upward and downward bound track.
  • FIG. 1E illustrates a cross-sectional view of the bone plate shown in FIGS. 1A and 1B taken from a location showing having only downward bound track.
  • FIG. 2A illustrates a top isometric view of a bone cutting guide according to one embodiment of the present invention adapted for use in an ulnar shortening osteotomy.
  • FIG. 2B illustrates a bottom isometric view of a bone cutting guide according to the embodiment shown in FIG. 2A .
  • FIG. 2C illustrates a rear elevational view of the bone cutting guide shown in FIGS. 2A and 2B .
  • FIG. 3 illustrates the sequence for assembly of the bone plate and bone cutting guide shown in FIGS. 1A-E and 2 A-C.
  • FIG. 4 illustrates the bone plate and bone cutting guide of FIGS. 1A-E and 2 A-C after assembly.
  • FIG. 5 illustrates the bone plate FIGS. 1A-E implanted on an ulnar bone after cutting.
  • FIGS. 1A-E shown are various views of a bone plate ( 100 ) according to one embodiment of the present invention adapted to perform an ulnar shortening osteotomy.
  • the bone plate shown is used to guide the surgeon, together with the cutting guide shown in FIG. 2 , to precisely cut the desired length from the ulnar bone, to rejoin the two ends of the bone, and to stabilize the rejoined bone ends in compression to promote their subsequent fusion.
  • the bone plate ( 100 ) comprises a substantially elongated metal plate having tapered distal ( 101 ) and proximal ( 102 ) ends.
  • the bone plate ( 100 ) further comprises a bone contacting side ( 103 ) and an opposite side ( 104 ) a left sidewall ( 110 ) and a right sidewall ( 111 ).
  • the bone contacting side has a generally cylindrical concave shape which generally conforms, or can be bent to conform, the contour of the bone to be treated.
  • the bone plate also includes a proximal elongated slot ( 105 ) and a distal elongated slot ( 106 ) which can be threaded or unthreaded.
  • the bone plate ( 100 ) further comprises one or more threaded or unthreaded bone screw holes ( 107 a - d ,) suitable for cortical bone screws or pegs.
  • Some of the bone screw holes ( 107 a , 107 b , 107 c ) may be adapted for installation of bone screws substantially normal to the bone contacting surface, while others ( 107 d ) may be adapted for installation of oblique screws.
  • Oblique screws are particularly useful to apply additional compression to rejoined bone ends that have been cut at an oblique angle where the screw can be inserted substantially normal to the angle of the cut.
  • a recess ( 109 ) Disposed on the opposing side ( 104 ) of bone plate ( 100 ) is a recess ( 109 ) adapted to receive the tip of a reduction forceps.
  • a left track ( 112 ) and a right track ( 113 ) Located respectively in the left and right sidewalls ( 110 , 111 ) of bone plate ( 100 ) are a left track ( 112 ) and a right track ( 113 ) extending longitudinally along the length of bone plate ( 100 ).
  • Tracks ( 112 , 113 ) extend proximally from a track limit point ( 119 ).
  • the left and right tracks ( 112 , 113 ) are mirror images and substantially identical with symmetrical placement along the left and right walls ( 110 , 111 ) respectively. However, this is not necessary as long as the tracks are adapted to engage corresponding features (shown in figures described below) in cutting guide ( 200 ). As shown in detail in FIG.
  • the track comprises an upper bounding wall ( 114 ) and a lower bounding wall ( 115 ).
  • Lower bounding wall ( 115 ) extends for the entire length of the track while the upper bounding wall ( 114 ) only extends partially from the distal end of the track ( 119 ) to a location ( 117 ) before the proximal end of the track ( 118 ) creating an overhead entry ( 116 ) to the track.
  • FIG. 1D shows a cross-section of bone plate ( 100 ) at a location where the tracks are bound by the upper and lower bounding walls ( 114 , 115 ).
  • FIG. 1E shows a cross-section of bone plate ( 100 ) at a location where the tracks are bound only by the lower bounding wall ( 115 ).
  • Laser etched, or otherwise affixed to the opposing side ( 104 ) of the bone plate ( 100 ) is a series of indicia ( 120 ), including a zero-mark line ( 121 ) used to measure the proximal-distal movement of the cutting guide ( 200 ) relative to the bone plate ( 100 )
  • FIGS. 2A-C shown are various views of a bone cutting guide ( 200 ) according to one embodiment of the present invention adapted to perform an ulnar shortening osteotomy.
  • the shown embodiment of bone cutting guide ( 200 ) is adapted to cooperate with the bone plate ( 100 ) shown in FIGS. 1A-E .
  • the bone cutting guide ( 200 ) comprises a handling feature ( 201 ) which can optionally be textured and oriented in a generally horizontal plane having proximal and distal edges ( 212 , 213 ). Extending downwardly from the left and right side of the handling feature ( 201 ) respectively are guide walls ( 202 , 203 ) which terminate in left ( 204 ) and right ( 205 ) horizontal guide blades.
  • the left and right guide blades ( 204 , 205 ) are situated on the bone cutting guide ( 200 ) so as to precisely mate with the left and right tracks ( 112 , 113 ) of the bone plate ( 100 ).
  • the interior space ( 206 ) bounded by the handling feature ( 201 ), guide walls ( 202 , 203 ) and the left and right guide blades ( 204 , 205 ) is sufficiently large to permit the bone plate ( 100 ), once the guide blades ( 204 , 205 ) are mated to the tracks ( 112 , 113 ), to glide in the proximal-distal direction without interference from the bone cutting guide ( 200 ).
  • the distal movement of the cutting guide ( 200 ) will be constrained by the track limit point ( 119 ).
  • the cutting guide further comprises an arm ( 207 ) which extends distally from one side (left or right) of the handling feature ( 201 ), or from the guide walls ( 202 or 203 ) as shown in the illustrated embodiment. Extending downward from the distal end of the arm is a flange ( 208 ) which incorporates a cutting blade slot ( 209 ).
  • the blade slot ( 209 ) is adapted to guide a blade from standard oscillating surgical saw or other similar bone-cutting device (not shown) to make a set of precise parallel bone cuts in the target bone.
  • the flange ( 208 ) may optionally comprise a secondary blade slot ( 210 ) parallel to, and located proximal of, blade slot ( 209 ) to permit for the making of additional cuts at a known offset (in this case 4 mm) from the first cut without requiring sliding of the cutting guide ( 200 ) on the bone plate ( 100 ).
  • additional blade slots may optionally be included on flange ( 208 ) to make cuts at different standard offsets from the first cut.
  • Cutting guide ( 200 ) may also optionally include one or more Kirschner Wire (K-Wire) holes ( 211 ) on one or both of the guide walls ( 202 , 203 ). These K-Wire holes ( 211 ) are obliquely oriented and adapted to guide K-Wires into the target bone to temporarily lock the position of the cutting guide ( 200 ) relative to the target bone. Alternatively, the position of the cutting guide ( 200 ) may be locked by using a lock screw or clamp (not shown) between the cutting guide ( 200 ) and the bone plate ( 100 ).
  • K-Wire Kirschner Wire
  • step 2 the cutting guide is moved downward until the tracks ( 204 , 205 ) are resting on lower bounding walls ( 115 ).
  • step 3 the cutting guide ( 200 ) is slid distally in relation to bone plate ( 100 ) until the distal movement is constrained by the track limit points ( 119 ).
  • this exemplary illustration demonstrates the cutting guide ( 200 ) engaging the bone plate ( 100 ) from the overhead position
  • the system of the present invention also permits the cutting guide ( 200 ) to engage the bone plate ( 100 ) from the rear position.
  • proximal elongated slot ( 105 ) use a drill of appropriate size (and optionally drill guides if using locking screws) to place a cortical screw, of appropriate length, into the proximal long slot ( 105 ) in the most proximal position.
  • proximal elongated slot ( 106 ) use a drill of appropriate size (and optionally drill guides if using locking screws) to place a cortical screw, of appropriate length, into the proximal long slot ( 106 ) in the most proximal position.
  • cutting guide ( 200 ) align and install on bone plate ( 100 ), using the procedure previously described, the appropriate cutting guide ( 200 ) (transverse (not shown) and oblique ( FIGS. 1A-E , 2 A-C) options are available) to the bone plate ( 100 ). Position cutting guide ( 200 ) such that proximal edge ( 213 ) is just distal of the zero-mark line ( 121 ). Use two K-Wires to temporarily fix the cutting guide ( 200 ) by driving them into the K-Wire holes ( 211 ) on the cutting guide ( 200 ) and into the bone.
  • Each laser etched indicia line ( 120 ) on the bone plate ( 100 ) corresponds to an additional osteotomy length of 2 mm.
  • Use two K-Wires to again temporarily fix the cutting guide ( 200 ) by driving them into the K-Wire holes ( 211 ) on the cutting guide ( 200 ) and into the bone.
  • an oblique lag screw may be placed across the osteotomy interface. Use a drill of appropriate size to place a cortical lag screw, of appropriate length, into the oblique bone screw hole ( 107 d ) of the bone plate ( 100 ).

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Neurology (AREA)
  • Pathology (AREA)
  • Surgical Instruments (AREA)
US17/082,862 2019-10-29 2020-10-28 Osteotomy system and method of use Active US11026698B2 (en)

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Application Number Priority Date Filing Date Title
US17/082,862 US11026698B2 (en) 2019-10-29 2020-10-28 Osteotomy system and method of use
US17/324,815 US11701129B2 (en) 2019-10-29 2021-05-19 Osteotomy system and method of use

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US201962927325P 2019-10-29 2019-10-29
US17/082,862 US11026698B2 (en) 2019-10-29 2020-10-28 Osteotomy system and method of use

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US (2) US11026698B2 (fr)
EP (2) EP4137076B1 (fr)
JP (1) JP7499324B2 (fr)
AU (1) AU2020376839C1 (fr)
ES (2) ES2999104T3 (fr)
WO (1) WO2021087033A1 (fr)

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Publication number Priority date Publication date Assignee Title
CN117084747B (zh) * 2023-09-07 2025-08-26 中国人民解放军陆军军医大学第一附属医院 一种转动截骨缩短器

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US20070276383A1 (en) 2006-05-11 2007-11-29 Rayhack L.L.C. Osteotomy system
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US20100168799A1 (en) * 2008-12-29 2010-07-01 Schumer Evan D Ulnar osteotomy plate including increased compression
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US5042983A (en) * 1989-10-30 1991-08-27 Rayhack John M Precision bone cutting guide
US7540874B2 (en) 2004-05-27 2009-06-02 Trimed Inc. Method and device for use in osteotomy
US8652142B2 (en) 2006-04-28 2014-02-18 Acumed Llc Osteotomy systems
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US9023052B2 (en) 2010-03-04 2015-05-05 DePuy Synthes Products, Inc. Ulna osteotomy system
US20130253592A1 (en) * 2010-12-01 2013-09-26 D.L.P. Device for compressing two bone parts
US9902498B2 (en) * 2011-05-12 2018-02-27 Airbus Operations Gmbh Device for the attachment of seats in passenger cabins, a seat track, a holding device, and a method
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US20180049785A1 (en) * 2016-08-17 2018-02-22 Globus Medical, Inc. Stabilization systems

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ES3006996T3 (en) 2025-03-19
CA3157987A1 (fr) 2021-05-06
US11701129B2 (en) 2023-07-18
AU2020376839C1 (en) 2025-05-01
EP4051136A1 (fr) 2022-09-07
JP7499324B2 (ja) 2024-06-13
JP2023500484A (ja) 2023-01-06
ES2999104T3 (en) 2025-02-24
EP4137076B1 (fr) 2024-12-04
EP4051136B1 (fr) 2024-09-18
AU2020376839A1 (en) 2022-04-21
EP4137076A1 (fr) 2023-02-22
AU2020376839B2 (en) 2024-12-19
EP4051136A4 (fr) 2023-11-29
WO2021087033A1 (fr) 2021-05-06
US20210267606A1 (en) 2021-09-02
US20210137534A1 (en) 2021-05-13

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